#289 - Help! My Child is Behind on Their Milestones- What Do I Do??

Developmental delays can happen for a variety of reasons- there’s no one to blame and you are not doing anything wrong!

We’re going to share some of the typical developmental milestones so you can identify if your little one is on track or a little behind, what you can do to support their development, and who to reach out to and get more help from.

We dive into gross motor, fine motor, oral and feeding, speech, emotional, and social milestones. We also give you 2 activities to add into the daily routine within each category!

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Developmental Milestone Chart
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Transcript

Rachel: 0:00

So just know that developmental delays can happen anytime to anyone and whether your child has a diagnosis or not, whether they're going to get a diagnosis in the future. If they don't have a diagnosis and they don't need one, developmental delays can just happen. Something happens to the brain in the body and the connection gets mixed up and their body just doesn't develop the way that it's intended to. I'm Rachel.

Jessica: 0:31

And I'm Jessica. And this is All Things Sensory by Harkla.

Rachel: 0:34

We are both certified occupational therapy assistants and together with Harkla, we are on a mission to empower parents, therapists and educators to help raise confident and strong children of all abilities.

Jessica: 0:46

On this podcast, we chat about all things sensory diving into special needs, occupational therapy, parenting, self care, overall health and wellness, and so much more.

Rachel: 0:56

We're here to provide raw, honest and fun strategies, ideas and information for parents, therapists and educators as well as other professionals to implement into daily life.

Jessica: 1:07

Thank you so much for joining us.

Rachel: 1:13

H eyeveryone, welcome. Welcome to all things sensory. This is the place where we talk about all things sensory, aren't you happy you're here? I hope you are.

Jessica: 1:21

Today, we're gonna talk about developmental milestones and what happens if your child, your clients are behind on their developmental milestones. What you can do. We're going to provide you with some super simple activities for babies and toddlers that promote development from a sensory perspective, of course. So let's do it.

Rachel: 1:47

Yeah, we just wanted a place for if someone stumbles upon our podcast, and maybe they have a child, birth to three years old, I feel like, I just want to make sure that they're not behind on their milestones, or I'm feeling like my child might be behind on their milestones, what do I do? What's the typical range? So we're going to run through some gross motor, fine motor, feeding speech, emotional, social milestones, and then we're going to give you some advice and suggestions for what to do if you think your child is behind on their milestones. And, like Jessica already mentioned, activities for your baby and toddler.

Jessica: 2:28

Just need to make sure that everybody heard it.

Rachel: 2:31

Just really want to make sure you listen to the entire episode, because it is a good one.

Jessica: 2:34

All right, so let's talk about developmental delays. Now developmental delays can happen for a variety of reasons. There's no one to blame. You're not doing anything wrong, chances are, and I just want to throw it out there. I was just thinking of babies who are neglected. Those babies often have developmental delays because of their circumstances. But chances are, if you're listening to this episode, you're doing the best that you can with as much knowledge as you have and we're about to give you some more. So just know that developmental delays can happen anytime to anyone and whether your child has a diagnosis or not, whether they're going to get a diagnosis in the future. If they don't have a diagnosis, and they don't need one, developmental delays can just happen. Something happens to the brain and the body and the connection gets mixed up and their body just doesn't develop the way that it's intended to. So just know that there's no blame. Can happen for any reason. We're not really going to dive into the reasons or anything like that. What we're going to share with you next are the typical developmental milestones and we've broken them up into categories. So if you have a baby or a toddler, if you work with babies and toddlers, we're going to kind of just run through it. We're not going to go into tons of detail. So if you do want to take notes, just know that you can always rewind the episode and relisten.

Rachel: 4:06

If you are in need of more help, more strategies, more information, we do have our infant and toddler sensory development course available, which we actually go through all of these milestones and more in that course. We give you red flags that you need to be aware of, and then we give you tons of activities for the sensory system, primitive reflex integration as well. So definitely check that out if you are like, you know what, I just need all the info. We've got you there.

Jessica: 4:36

Alright, the first ones that we're going to go through are the gross motor milestones and these are like the full body movements that we want babies and toddlers to be able to do. So we want babies to be rolling by about four months, sitting on the floor and supported by about six months, we want to see them crawling on all fours hands and knees between eight and 10 months before they start walking, and then we want to see walking anywhere between 12 and 16 months. We want to see them running by about 18 months and then we want to see two foot jumping by around two years, give or take a month or two on each side of these. But if your baby is seven months old, and they're not independently rolling from their tummy to their back and their back to their tummy, just know that they might be missing that rolling milestone.

Rachel: 5:38

And you might be thinking like, well, what if they don't roll, they just go straight to sitting or what if they don't crawl, they just go straight to walking? There's a reason why these are called milestones, it's because they build on one another and we need those movements in order to facilitate successful achievement of these more advanced milestones. I also want to mention we're not following the CDC guidelines for .

Jessica: 6:02

Disclaimer.

Rachel: 6:03

These milestones. We don't agree with them. We don't agree with the changes the updates that they made after COVID.

Jessica: 6:09

After they took crawling out.

Rachel: 6:10

Yeah, so this is more of like an occupational therapy milestone chart, and we'll post, we'll share the link of the full chart in the show notes. You can check it out if you want to see the full thing and you're curious about that, but just a little FYI.

Jessica: 6:25

Next are the fine motor milestones. So by about three to four months, we want the baby to be able to bring objects to their midline. So that's with both hands. By about six months, we want them to be banging objects together while they're sitting. So they're holding one block in each hand, and they're bringing the blocks to midline and bringing them together. They can also be clapping. By about 10 to 12 months, we want to be able to see them using what's called a pincer grasp, which is their thumb and index finger. We want them to be able to efficiently use that pincer grasp for small items such as small cereal pieces or small toys. By about 13 to 16 months, we want them to be scribbling on paper, markers, crayons, and for that activity to be interesting to them. By about 17 to 20 months, we want them to be able to build a block tower with six blocks. Not the little like small blocks, but like a good size block. By about two years, we want them to be imitating circular strokes and so this is called a prewriting stroke. We want them to be able to watch you draw a circle and for them to imitate the circle. By about two years, we want them to be starting to snip with scissors. So that's not full cutting, but that's just being able to open and close the scissors to snip the edge of a piece of paper. By about two years, we want them to be able to throw a ball to a target a couple feet away. And by three years, we want them to catch a large playground ball with both hands.

Rachel: 8:15

I feel like the gross motor milestones are the ones that people like focus on, but there are so many others.

Jessica: 8:23

And it's important to keep in mind too that the gross motor milestones affect the fine motor milestones. So if your child is unable to sit unsupported by around six months, chances are they're not going to be able to bring objects and together at midline by six months.

Rachel: 8:42

Yep.

Jessica: 8:42

So just keep in mind that these milestones do affect each other specifically gross motor will affect fine motor development.

Rachel: 8:50

Absolutely. Alright, some oral feeding milestones. Generally, we want to see our good latch when the baby's born, suck, swallow, breathe all of that good. We've ruled out tongue ties, lip ties, all the ties.

Jessica: 9:04

All the ties.

Rachel: 9:06

By around six months, that is when we're going to generally start feeding if the child is sitting unsupported. If they're not able to sit up unsupported, then we don't want to start feeding because if we can't support our trunk and keep our trunk in an upright position, it's not going to be safe to be swallowing foods.

Jessica: 9:26

And that does affect head control. So if your baby does not have good solid head control at six months, then that's also an issue.

Rachel: 9:35

Exactly. So generally speaking, open cup drinking, straw cup drinking usually starts to happen around eight months. Self-feeding using your pincer grasp begins around nine to 12 months, like Jessica mentioned earlier. That pincer grasp grabbing cereal and bring it to mouth for the fine motor milestones is about 10 to 12 months so around the same age. They start to self feed using utensils, not well, by around 13 to 16 months, and then by about two is when they should be eating a variety of food and using utensils pretty well.

Jessica: 10:11

And I think it's important to keep in mind too, that exposure is necessary to achieve some of these milestones. So if you never present your eight month old with an open cup to try to drink from, they'll never learn. So you do have to keep in mind that you have to give your baby, your toddler exposure to these experiences in order for them to achieve these skills. Okay, next on the list, this one's kind of long, so bear with us. Speech, emotional and social milestones, we've lumped these all together. By four to six months, we want baby to be laughing and giggling. By about seven months, we want them to attempt to imitate sounds. By seven to nine months, we want them to intentionally look at objects that are talked about. So if you point to the cow, during your walk, they will intentionally follow and they will intentionally turn and look towards where you are pointing. They might even imitate your point and try to imitate the sound cow or the word cow or dog, whatever. Between seven and nine months, you might notice that they have some stranger danger with new people. By 10 to 12 months, we want to be hearing one to two word vocabulary so mom, dad, no. That's a big one and they're going to be using those words in a meaningful way. So they know who Mama is. They know who daddy is. They know what the cow is. They know what the dog is. By around 12 months, they are understanding simple phrases. So you know, look at dad, and they know what that means and they can do it.

Rachel: 11:57

Yeah. And similarly about this stage, they are following those commands too. Go pick up your shoes and they understand those simple phrases.

Jessica: 12:04

Clap your hands, and then the stuff, Yes.

Rachel: 12:07

Yep. By around 12 months, they're gonna bring toys to their caregivers. This is when they're going to start handing you some of their toys. Almost like a sharing activity, they want to show you their favorite toys. Around 12 months, they're going to engage in dressing. So they might try to take clothes off or even try to put clothes on, but not going to do it well, but they're trying they're engaging in it. Around 12 months, there's a lot that happens around this 12 month period, but just keep in mind, give or take a month or two on either end before you start worrying. So 14 months, begins engaging in interactive games and songs. So like wheels on the bus, head, knees, head, shoulders, knees and toes. You think I would know that song better. By 13 to 16 months, we want to see a vocabulary of 10 to 20 words. Good luck counting that. It's funny because Daniel and I were talking about this with Austin today because she's going to be 18 months this month. And I was like Daniel, did you know that by 18 months, she should have 50 words. And he's like, there's no way she has 50 words. And I'm like, I'm just like kind of counting. She might, I don't know.

Jessica: 13:17

Good luck counting that. By 13 to 16 months, they're going to be repeating words that they hear during conversations.

Rachel: 13:25

This is a dangerous one.

Jessica: 13:26

Yep, yep, stop, stop your swearing around this time, right? Between 13 and 16 months, they should be able to follow simple commands and answer questions and follow those instructions more efficiently. By 13 to 16 months, we want them to be pointing and clapping and really engaging in those intentional activities. By two years old, we want them to be using two word phrases and have that vocabulary of 50 words or more, that Rachel mentioned. And then by three years, we want to have strangers, that are not familiar with the child, understand about 75% of what they're saying. So to be intelligible.

Rachel: 14:07

Yeah.

Jessica: 14:08

Is that the right word? Intelligible?

Rachel: 14:09

I think so.

Jessica: 14:10

I hope so. Someone will correct me if I'm wrong.

Rachel: 14:14

So that's a lot to keep in mind, but I think it's just I really love this stuff. Maybe it's just the field that I'm in, but I love like milestones and practicing these things and like being aware of them and incorporating playful activities into our daily routine that are going to work on these milestones. But let's say you're here because you feel like there are some delays and your child might be a little bit behind. You're are concerned. What do you do if you're having these concerns and you want to double check? So the first thing is to chat with your pediatrician. Advocate for getting an OT eval(occupational therapy), a PT(physical therapy), or speech therapy evaluation depending on gross motor, or with fine motor, or speech delays that you're noticing. Oftentimes, PTs are the ones who will help your child learn to roll and crawl and walk, and run. And speech therapies, like I mentioned, the emotional, speech, language, social aspect. And, oftentimes, we get people reaching out saying that they either, you know, their pediatrician says they're fine, just wait and see.

Jessica: 15:30

They'll grow out of it.

Rachel: 15:31

Yeah, or boys develop later than girls. And it's just so frustrating as therapists to hear people telling us this. You know, your child, you know what you need. Advocate. Don't leave the doctor's office without a referral, if that's what you need in order to get the services.

Jessica: 15:48

Yeah, instead of the phrase wait and see, we prefer when in doubt, rule it out. So if you do push to get an evaluation, because you're noticing some delays or some concerns, and you go get the evaluation, and you learn that maybe your baby is a little bit behind, but they're not so far behind, and they're still developing, or maybe you learn, yeah, my baby is behind, and they need a few sessions of OT or speech or PT to get caught up. You never know until you go and find out.

Rachel: 16:20

One of my friends had a baby, her second baby, who we consider like a happy sitter, and would just sit and he never needed to crawl or move. And so she was asking me, I'm like, just go get a PT referral. Go see a PT and she went, and then worked on it, and homeboy is crawling, and now he's walking, and he just needed a little kick in the right direction. Because had she not have reached out and gotten help, he probably would have skipped crawling. He probably would have gotten even further behind. So there's really nothing wrong with getting help and needing services. And I just feel like we need to take the shame and the blame out of your child needing a little assistance. If anything, more power to you for recognizing it and getting the help.

Jessica: 17:11

Yeah, absolutely. Air high five. And oftentimes, we'll hear that the pediatricians don't want to make the referral, or they do begrudgingly and

Rachel: 17:22

Sometimes they do sometimes they make the referral.

Jessica: 17:24

Absolutely. But if your pediatrician is giving you pushback. If they're not believing you, whatever it is, just know that you can always go find a new pediatrician. You don't have to stay with that one pediatrician, who's giving you grief for your concerns.

Rachel: 17:40

If you guys remember, I've talked about this before, I think I went through three pediatricians. I think I'm on my fourth maybe. So you got to do what you got to do.

Jessica: 17:48

Got to do, what you gotta do. All right. Now to finish off this episode, we are going to give you one activity to do within each of the categories that we talked about. One activity for your baby, if you have a baby, work with babies, and one activity for your toddler.

Rachel: 18:04

Gross motor. When you have a little baby, you can also do this with a toddler, tummy time over the therapy ball. So help support them on the therapy ball, on the yoga ball. Support them in tummy time, get down in front of them, look at them, talk to them, sing to them, play with them. During your tummy time.

Jessica: 18:22

And for your toddler, get them crawling through tunnels. You can get a pop up tunnel. That's super fun. You can use couch cushions, the nugget couch, you can use blankets and chairs to create tunnels, but get your toddler down on their hands and their knees with their hands open and flat on the floor and crawl through some tunnels.

Rachel: 18:43

For our fine motor milestones. For babies to provide some tactile stimulation to the hands and palms. This could be anything from a massage, vibration using a vibrating ball, this could be a wet or dry washcloth, a hairbrush, the carpet. Just provide some novel tactile stimulation to their hands.

Jessica: 19:07

And for toddlers get them engaged in sensory bins with dry and wet tactile mediums. So this could be a sensory bin of beans and magnet letters or just magnet shapes or animals. This could be messy food play. This could be shaving cream, water table, any type of sensory bin. Do it on the regular.

Rachel: 19:32

For our oral motor and feeding milestones. For a baby, as soon as baby's born, you can get in their mouth. Use your fingers, stretch their cheeks, lift their tongue, help them move their tongue side to side, help them elevate it and lift it up. Provide that stimulation inside of their mouth outside of their mouth, on their cheeks and on their lips just get them used to different textures around their mouth and in their mouth.

Jessica: 19:57

For toddlers, we want them to be doing lots of messy food play. So we want them to touch their food as much as possible. Off air, Rachel and I were talking about pouches and while pouches are super convenient and helpful; unfortunately, it doesn't allow for your toddler to see or engage with the food that's inside the pouch. So as much as possible, get your toddler engaged with touching and playing with their food, either during mealtime but also during playtime.

Rachel: 20:30

If they want one of those pouches for snacks, just grab it and have them squeeze it into a bowl and then use a spoon to feed it or feed themselves.

Jessica: 20:39

Yep.

Rachel: 20:39

For speech, emotional and social milestones. For our babies, you're going to narrate everything,

Jessica: 20:46

You're going to point to that cow.

Rachel: 20:49

You're going to point to the cow. You're going to talk about the cow's tail and the colors of the cow and what the cow is probably thinking. Maybe he's hungry, he's eating some grass. Oh, he just pooped, yucky, it's stinky. All the things, you're just going to talk about all the things. All the time. You should be exhausted and want to be done talking by the end of the day, after you've been hanging out with your baby.

Jessica: 21:13

For toddlers, we want to practice identifying emotions. You can identify your own emotions, you can ask your toddler what emotions they feel, you can ask your toddler, what they think other people are feeling based on facial expressions. You can use pictures of people making different facial expressions and talk about what that person might be feeling. Maybe what happened to that person to cause them to feel like that and really start incorporating emotional identification into the everyday routine.

Rachel: 21:48

Today in the car on the way to preschool, Trip and I were making faces for different feelings. And the car is a great time. Also, the dinner table or the meal table as Jessica likes to call it. Because they're like, if they're in a highchair or in a car seat, they're strapped in, they can't go anywhere. So you can really work on that stuff and you can be silly and play with it. Yeah.

Jessica: 22:11

Yeah. So incorporate those activities into the daily routine. Exposure is key, just keep that in mind. Keep in mind that all of these developmental milestones build off of each other. They're important. They help your baby develop and grow and learn and all kinds of things. So.

Rachel: 22:34

If you liked this episode, if you want more about this and more information to build on this, then definitely check out our infant and toddler sensory development course. We talked about sensory integration. We talked about primitive reflex integration. It's a really cool course. At the time of recording this in November, I'm not sure when it's going to launch. But we are currently updating it and we're adding more to it. We're adding more videos, more real life kiddos to it. If you purchase it now, you'll get access to the update. We're also adding AOTA CEUs for our therapists out there. So it's definitely one to check out. We will link it in the show notes for you to check out. As well as anything else we talked about, we will link that as well.

Jessica: 23:21

Let us know if you liked this episode. You can send us a message on Instagram. You can screenshot this episode and tag us. We're at all things sensory podcast. Let us know your thoughts on this topic. Let us know if your child is receiving services to help meet their milestones. Share this episode with a friend.

Rachel: 23:40

Thank you for being here. Thank you for listening to us. Hope you had a good time and learn something new. And we will plan on chatting with you next Wednesday. Thank you so much for listening to All Things Sensory by Harkla.

Jessica: 23:53

If you want more information on anything mentioned in the show, head over to Harkla.co/podcast to get the show notes.

Rachel: 24:02

If you have any follow up questions, the best place to ask those is in the comments, on the show notes, or message us on our Instagram account which is at Harkla_family or at all things sensory podcast. If you just search Harkla, you'll find us there.

Jessica: 24:18

Like we mentioned before our podcast listeners get 10% off their first order at Harkla. Whether it's for one of our digital courses or one of our sensory swings, the discount code sensory, will get you 10% off.

Rachel: 24:36

Head to Harkla.co/sensory to use that discount code right now.

Jessica: 24:42

We are so excited to work together to help create confident kids all over the world. While we make every effort to share correct information we're still learning.

Rachel: 24:51

We will double check all of our facts but realize that medicine is a constantly changing science and art.

Jessica: 24:56

One doctor or therapist may have a different way of doing things from another.

Rachel: 25:00

We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties, and what we have found to be beneficial that will be as evidence based as possible.

Jessica: 25:12

By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your child.

Rachel: 25:20

Consult your child's pediatrician or therapist for any medical issues that he or she may be having.

Jessica: 25:26

This entire disclaimer also applies to any guests or contributors to the podcast.

Rachel: 25:31

Thanks so much for listening